People don’t make it easy to be a breastfeeding mom, especially in Pakistan
“Are you still breastfeeding your baby?”
“Yes, I am!”
“Kab tak karo gi [how long will you do this for]? Aren’t you tired? Bottle laga do. Asani hojae gi [give a bottle. It’ll be easier].“
Yes, I am exhausted. I have been exclusively breastfeeding my child for 18 months now. He is on the weaning-off journey and usually, I am only supposed to give him night feeds.
Indeed, it has been a long, tedious and mostly lonely journey that is physically, mentally and emotionally demanding — and draining too. Nonetheless, it has made motherhood wholesome, and satisfied the urge to give and do the best for my baby.
Breastfeeding is a path I choose for myself and my baby but it was not easy. Strangely, I met with plenty of opposition, missed out on many opportunities and was constantly advised “bottle laga dou [give a bottle]”.
Full disclosure — I am not against bottle feeding. Somedays, I really wanted to just hand him a feeder. I tried too. Yet, my determination, faith and my baby’s needs overpowered everything. And like they say, “Agar kisi cheez ko dil se chaaho to puri kayanat usey tumse milane ki koshish mein lag jaati hai [If you truly want something, the whole world tries to make it happen.”
What to expect when you’re expecting
We always see mothers carrying baby bags, calculating the formula to water ratio and shaking the bottles aggressively before handing them to their crying infants. There were a few instances, which I remember, of women nursing their children, but not many in public spaces and if at all in public, I remember people feeling awkward about it.
In May 2020, I conceived my first child. It was a surprise conception during a pandemic; I was in uncharted territory and didn’t want the journey ahead to be unfamiliar. I went ahead, took matters into my own hands and started vigorously researching everything pertinent to pregnancy, motherhood and Covid-19.
Facebook groups, books such as What to Expect When Expecting and apps like Baby Center became my friends.
Priorities straight, I made lists of things I would need and want for my baby. Oddly, baby bottles were one of the very first items on the list because a baby needs the best nourishment to survive and mothers’ milk can only do so much, right?
I imagined I would feed him for about six months then my milk would dry up, as I often heard would happen. I invested in the right bottles; the colic type, the close-to-nature ones, the ones whose nipples resembled breasts and whatnot. I also researched the best formulas in town and every time I would go through the ingredients it would say closest to nature, as close to the mother’s milk as possible with added nutrients.
It struck me as odd at times.
We are constantly bombarded with promotions of formulas, diapers and the best baby food (even though some countries have banned such advertisements). Consequently, whether you have a kid or not, you are compelled to believe that this is the best for infants.
Being someone who tries her best to eat healthily, not have fizzy drinks or add unnatural items to my diet and avoid increasing my carbon footprint — the ingredients and assurances on these formulas weren’t inviting.
It wasn’t until I joined some breastfeeding groups on Facebook, via some mommy groups, that my world flipped and I realised that if I like to eat clean, why would I choose otherwise for my offspring? For the safest, healthiest growth of my child, nursing was the best way forward.
In Pakistan, only four in 10 babies are exclusively breastfed for the first six months. According to Unicef, Pakistan has the lowest ratio among developing countries.
The benefits of breastfeeding for children and mothers are multifaceted. They are time and again proven by science and religion. It not only improves the bond between the mother and child, but it also aids healthy brain development, protects infants against infection and decreases the risk of obesity and diseases, not to forget the reduced medical costs and protection against ovarian and breast cancer.
It can also combat new infections and diseases.
Here began the journey to understand how breastfeeding works.
While shopping, I made sure we had no formula at home. Not only did it cut the budget but also “na rahega baas na bajegi bansuri [treating an issue at the source]”.
While I made sure my gynaecologist and husband knew how I wanted to deliver my baby, I also shared my wish to get skin-to-skin and nurse at birth.
I was amazed to find that in a country that delivers more than 18,000 babies every day, there weren’t any lactation specialists at hospitals. Nurses were ‘trained’ to guide new moms but breastfeeding isn’t taken seriously here. While it is supposedly the most natural thing, I believe because of the lack of attention to the process, it has significantly reduced in the country.
Post-delivery, I was indeed disoriented, yet I kept asking for my baby, for skin-to-skin contact but he was taken to get cleaned. A nurse came in after I was stitched to check if I was lactating. I wasn’t. They gave my baby, Kian, a bottle, even though I kept asking for him. I knew from the Facebook groups that breasts aren’t supposed to be squeezed to let milk out, especially right after birth. Only the right latch and sucking will send signals to your body to produce milk. Also, in the first few days, colostrum or gold milk is produced, which strengthens the baby’s immune system.
I got to see my baby about two hours post-birth after he was given formula. He cried a little later that night and when I tried feeding him, it was easy. I thought he latched onto me and fed but he was hardly sucking and he was so tiny. He slept for a good while and wouldn’t wake up to feed, even though the nurses kept trying. After a while, I was told that my child’s blood pressure was low and we had to feed him formula. Hence, he was given formula yet again.
I was back home within 24 hours of delivery. That is when I was tested. Fortunately, my in-laws and my husband were on board, and a crying child and restless mom didn’t irritate anybody. I was taken care of immensely while I attempted to comprehend what was required. It took me a week of feeding him like clockwork, latching him rightly with engorged, painful and sore breasts, a crying baby and no sleep to understand the method. After many sleepless nights (which are common after childbirth), we were finally on a healthy breastfeeding journey. Yet, little did I know I would have to face many more obstacles.
Babies should not be introduced to a bottle in the first six weeks to avoid nipple confusion, yet, I knew I had to get back to work at some point, which meant at least eight hours without feed. That’s impossible for a baby below the age of one, hence he needed to be fed by bottle, a sippy cup or a spoon. I started pumping and storing milk but it wasn’t enough in the beginning. When the baby feeds themselves, the removal is much greater than with the pump.
Luckily or unfortunately, my baby never accepted the bottle — I had to resort to spoon or dropper feeding, which felt more of a job than a relief.
The lone road
I soon realised that Pakistan is not a mommy/baby-friendly country. The roads have no zebra crossings, no ramps for strollers, restaurants, malls and parks hardly have baby chairs or changing stations and there are no mother-friendly spaces to feed children. The lack of space for women in Pakistan has always been a topic of debate and I saw these spaces shrinking for me as a mother.
I remember standing and feeding my two-month-old in a Nadra office bathroom because the stalls were disgusting and there was no other place to go.
My partner in crime has since become a feeding cover I bought that has been my best buy ever. With a lot of courage, some shamelessness and support from my husband, I started breastfeeding in public — with the cover of course. I started wearing clothes that were looser and easier to manage in public.
Yet, I left the house less — shopping, eating out, and meeting people became tedious tasks. We would visit friends less often because I would have to find corners even in private spaces to feed my child. Even within my own house, if we had guests, I would rush to the room to nurse. It got lonely and no one could do much to help me.
The test began when I picked up a project three months postpartum. I flew to Karachi for my first gig as a mother. I was anxious to take the first flight alone with a newborn, but thankfully, skin-to-skin and breastfeeding soothes babies. Because Kian was young, he slept through the flight — and the return one.
The job was to write about a marginalised community in Pakistan. I had to interview people in rural areas, places far from the city or crowded locations within the city. At odd hours, in Karachi’s summer heat, everything that wasn’t very baby-friendly was at play, right on the first job. Thankfully, I had family to take care of my child and travel with me while I worked. Kian was breastfed between and during the interviews and accompanied me to every location. But it was not easy.
My line of work requires the utmost attention to details, surroundings and feelings of people to accurately report on the matter. With a baby who has his own needs and no realisation of the situation, things can get tough and did I mention mom brain?
I realised people treated me differently in different strata of society. In low-income areas, I was welcomed and made comfortable. They realised that I am a working mother who needs to tend to her child’s needs but in more affluent circles, I was always told to give him the bottle to make my life easier.
In September 2021 I enrolled in a master’s programme. My child was seven months old and had just started weaning off. Luckily, the university was welcoming and helpful. I hired a nanny who would take care of him in the common room and call me between classes when he needed to feed. He would feed once every two hours or so.
Something once happened during an examination that reminded me how not mommy-friendly our country is. We weren’t allowed to have phones on us during the exams and in the very first hour, I could hear my son crying. I had to ask the invigilator to let me feed him and I fed my child right outside the exam hall that day.
Yet, it does get easier as the feeds spread out. Soon, my circle also realised this is part of the package and if I was invited or wanted, the baby and the feeds would be accompanying me too.
When Kian was eight months old, we travelled to Skardu as a family. He was older, weaning off. This trip made me thank my stars for being a breastfeeding mom. We were hassle-free, from the issues of finding warm mineral water, sterilising bottles and taking formula with us. I could feed him anywhere, without fearing him becoming sick. We fed by the mountains, in the lake, in jeeps, trucks — everywhere it was needed.
It took a few months of struggle, challenges and missing out on things but I had a healthy baby. It is a tough journey, especially when you are constantly told you are wrong. There will be days of relief, some will be hard, especially when your baby is teething and does not want to let you go or move. Somedays, your baby might sleep through the night without a feed and you’ll wake up feeling fresh (a feeling one misses a lot), somedays they might not need a feed, just because, and you will feel unwanted.
We need to support moms who choose to breastfeed. I also realise it was a luxury because I was headstrong enough not to give in to the pressure. I was also forced to miss out on opportunities and I couldn’t work regularly. I wasn’t considered for jobs because I would ask for a pumping room, a daycare allowance and just the basic necessities a mom would need. We had to hire help so that I could do whatever little I had to.
Yet, everyone is on their journey. Join breastfeeding-friendly Facebook groups, and educate the people around you about its benefits. Get in touch with a lactation consultant, especially when you are pregnant, and invest in learning. Educate yourself and see what suits you, your situation and your baby the most.
Being a mother can never be a walk in the park, so whatever your choice, you are doing great mama!